Foundation trust governing boards have been criticised by a Conservative member of the Commons health select committee as “self-selecting cliques”, after figures revealed up to a third of elections for foundation trust governors are uncontested.

A parliamentary answer last week revealed one in five elections were uncontested in 2008-09, rising to 31 per cent of those for staff governors.

The reason so many are uncontested is they’re carried out very quickly with little publicity

Conservative MP Peter Bone, whose question prompted the release of the data, said: “The reason so many are uncontested is they’re carried out very quickly with little publicity.”

Calling the bodies “self-selecting cliques”, he said people had to register to vote and were not given enough time to nominate themselves as candidates.

There were 12,742 registered voters on average at each of the 115 foundation trusts. This is expected to rise by 12 per cent, to 14,267 in 2009-10.

On average, 27 per cent of registered electors who were members of the public turned out to vote, compared with 26 per cent of patients and 19 per cent of staff.

Mr Bone suggested elections should take place every four years alongside local elections to improve turnout.

He also said the matter warranted investigation by the health committee.

“There’s a number of [committee] members who are concerned about foundation trusts. We have some opportunity to bid for short investigations next year. That may be the way forward,” he said.

Foundation Trust Network head of communications Saffron Cordery said: “The average figure hides the fact that in some FTs the votes are contested to a much higher degree.”

More established foundations were likely to have embedded their governance processes and have better turnouts and more people standing as candidates, she said.

But she admitted the staff figures “stand out”, saying this was because there were often existing structures through which employees could raise issues.

Health committee chair Kevin Barron (Labour) said it was important to remember governing bodies were in their infancy.

But he said: “We’re looking at doing one-off evidence sessions before we get into the election and this is a subject we could look at in a bit more detail.”

Members had already discussed calling ministers in to discuss foundation trusts, he said. Mr Barron also plans to use an upcoming debate to probe ministers on whether foundations should be told to put patient safety on their board agendas.

Foundation trust regulator Monitor declined to comment on the figures on uncontested elections. Last week it published guidance clarifying governors’ statutory duties, including removing chairs and non-executive directors.

Guidance on FT governance powers

  • Before governors remove a trust chair there should be a vote of no confidence, a period to investigate and consult, a written report and a second vote. The annual report should contain an explanation.
  • Trusts should consider seeking governor approval before appointing a chief executive, to reduce delays after a decision has been taken.
  • Consideration should be given to the level of training needed by governors on nominations committees.
  • Governors should consider board directors’ views on the qualifications, skills and experience required for chair positions.

Source: Your Statutory Duties: a Reference Guide for NHS Foundation Trust Governors, Monitor.

HSJ’s conference Fundamentals of NHS Governance is on 17 November. For details, visit